Kidney/Renal Disease and Long Term Disability: What You Need to Know

Kidney and renal disease can cause serious and severe symptoms such as fatigue, nausea, swelling, and high blood pressure.  In some cases, these symptoms may become so severe that they interfere with your ability to work and perform daily activities.  If you are suffering from kidney or renal disease and find yourself unable to work because of it, you may be eligible for long term disability (“LTD”) benefits through your employer-sponsored or individual insurance policy.

However, applying for and receiving LTD benefits is not a simple or straightforward process.  There are many factors that determine whether you qualify for benefits and how long you can receive them.  Below, we’ll explain what you need to know about kidney and renal disease and long term disability, including how an experienced ERISA attorney can help you successfully secure the benefits you deserve.

Can I receive long term disability for kidney or renal disease?

Yes, you can receive long term disability (“LTD”) benefits for kidney or renal disease, but your eligibility largely depends on the specific terms of your long term disability insurance policy.  Each policy has its own definition of what constitutes a “disability.”  To get your claim approved, you will need to meet this definition of disability as it is laid out in your policy.  This often requires a detailed demonstration that your kidney or renal disease significantly impairs your ability to perform your job or any job, depending on your policy terms.  Your policy will include other stipulations, including waiting periods, time frames for the filing of claims, and periodic reviews of your medical condition to continue receiving benefits.  Your insurer will likely require proof that you are receiving appropriate and ongoing treatment for your condition as part of the eligibility criteria.

Consulting with a long term disability attorney may be beneficial, as they can provide guidance on compiling the necessary documentation, meeting all policy requirements, and handling any disputes that arise with your insurer over your disability claim.

What are the disabling symptoms of kidney and renal disease?

Kidney and renal diseases can manifest in various ways, each potentially leading to significant health complications.  The nature of kidney and renal disease symptoms can vary widely, but if they present with enough severity and frequency, they may lead to long term disability.

Some common kidney and renal conditions include:

• • Chronic kidney disease (“CKD”)
  • Nephrotic syndrome
  • Glomerulonephritis
  • Polycystic kidney disease
  • Acute renal failure
  • Kidney stones
  • Renal cell carcinoma

The physical symptoms of these conditions can be debilitating, including:

• • Severe fatigue and decreased energy levels, making it difficult to sustain regular work activities;
  • Swelling or edema, particularly in the legs and feet, which can impair mobility and stamina;
  • Pain in the back or side, which can be chronic and severe, affecting concentration and physical capability;
  • Frequent urination, especially disruptive if it affects sleep patterns and leads to fatigue; and
  • Hypertension, which can have secondary effects such as headaches and vision problems.

Cognitive symptoms might also arise, including:

• • "Brain fog" or difficulty concentrating, which can affect cognitive tasks and decision-making; and
  • Sleep disturbances from nighttime urination or discomfort, leading to fatigue and impaired cognitive functions.

The symptoms of kidney and renal diseases can profoundly impact your ability to work.  For example, the persistent exhaustion characteristic of these conditions can hinder the ability of a construction worker to safely operate heavy machinery or prevent a professor from managing a full day in the classroom, both of which require sustained energy levels and alertness.  Similarly, cognitive symptoms like “brain fog” can make it difficult for professionals such as lawyers or accountants to maintain the sharp focus needed for complex case analysis or detailed financial reporting.

These limitations not only affect the ability to perform specific job functions but can also make the broader aspect of maintaining any form of employment exceedingly difficult.  When these conditions are well-documented and submitted as part of a long term disability claim, they often meet the criteria set forth by insurance policies for disability benefits.

How do I prove my kidney or renal disease is disabling?

To prove that your kidney or renal disease is disabling and qualifies you for long term disability benefits, your insurer will require comprehensive evidence demonstrating that your condition prevents you from working.  This evidence can include medical documentation from your healthcare providers, vocational analysis showing how your symptoms affect your ability to perform your job or any job, and additional supportive materials.

Medical Evidence for Kidney and Renal Disease

To substantiate a claim for long term disability benefits due to kidney or renal disease, comprehensive and detailed medical evidence is key.  This evidence must convincingly demonstrate how your condition prevents you from maintaining employment.

Here are some types of medical evidence that can support your kidney or renal disease LTD claim:

• • Imaging Tests: Important diagnostic tools like ultrasounds, CT scans, or MRI scans provide critical visual evidence of structural abnormalities or damage in the kidneys.  These images can reveal conditions such as polycystic kidney disease or tumors.
  • Blood Tests and Urine Tests: These tests are fundamental in showing kidney function impairment.  Key indicators include elevated creatinine and urea levels, which signal renal filtration issues, and abnormalities in electrolyte balances or the presence of protein in the urine (proteinuria), which are indicative of kidney disease.
  • Kidney Biopsy Reports: A biopsy can offer definitive histological evidence of kidney pathology, confirming diagnoses of conditions like glomerulonephritis or interstitial nephritis, which may not be as apparent through other testing methods.
  • Office Visit Notes from Treating Doctors: The detailed notes from each visit to your healthcare providers are crucial, as they document the evolution of your condition over time.  These notes often include observations on symptom progression, responses to treatment, and notes on any side effects you may be experiencing—all vital details for your LTD claim.
  • Narrative Statements from Treating Doctors: Statements from your specialists, such as nephrologists, provide an authoritative perspective on your kidney disease.  These narratives should discuss the specifics of your diagnosis, your treatment regimen, the responses to treatment, and the long-term outlook.  Importantly, they should include detailed assessments of how your kidney disease impairs your ability to perform job functions, both physically and cognitively.
  • Functional Capacity Evaluation (“FCE”): A Functional Capacity Evaluation (“FCE”) is a comprehensive assessment that measures your ability to perform a range of physical tasks.  This evaluation can highlight specific limitations, such as how long you can stand, walk, or lift objects, which are essential for determining your capacity to work, especially in physically demanding jobs.
  • Neuropsychological Evaluation: If you experience significant cognitive symptoms as a part of your kidney disease—such as problems with concentration, memory, or other cognitive functions—a neuropsychological evaluation can provide a detailed and objective assessment of these issues.  This evaluation helps document the extent to which cognitive symptoms might interfere with your work tasks.
  • Dialysis Records: If your treatment regimen includes dialysis, these records not only show the necessity and frequency of this life-sustaining treatment but also underscore the severity of your kidney failure.
  • Documentation of Medication Side Effects: Many medications for kidney disease come with significant side effects that could impede your ability to function effectively at work.  Detailed records of these side effects can help support your claim for benefits.
  • Progress Notes and Hospital Discharge Summaries: These documents provide a continuous narrative of your health condition and treatments over time, painting a comprehensive picture of your medical history and current status, which supports your disability claim.

Collectively, this well-rounded medical evidence will help substantiate your claim, demonstrating that your kidney or renal disease significantly limits your ability to work.

Vocational Evidence for Kidney and Renal Disease

To prove that your kidney or renal disease results in a disability that prevents you from working, vocational evidence plays a crucial role alongside medical documentation.  This type of evidence helps illustrate the scope and specific requirements of your job, and how your condition impacts your ability to meet these demands.

Vocational evidence to support your kidney or renal disease claim may include:

• • Official Job Description: Your official job description from your employer provides a baseline for what your insurer will consider your “material job duties,” the essential tasks you must be able to perform.  It defines your role and outlines the physical and cognitive demands of your job.
  • Resume and Employment Background: Your resume and employment history offer a detailed view of your professional experience and skills.  This can help the insurer understand the level of work you are accustomed to and evaluate whether your kidney or renal disease might prevent you from performing not only your current job but any other job for which you are qualified based on your experience and skills.

• • Statements from Coworkers and Supervisors: Testimonials from people who work closely with you can provide insight into how your condition affects your day-to-day performance.  These witness statements can highlight changes in your ability to fulfill your duties over time, offering real-world evidence of how your kidney or renal disease have affected your work performance.

• • Vocational Assessment: A vocational expert can provide a vocational assessment to support your LTD claim.  The expert evaluates your work capabilities in light of your physical and cognitive limitations due to kidney or renal disease.  This assessment typically involves reviewing all the aforementioned documents and possibly conducting an interview with you.  The expert can then produce a report that discusses your ability to perform your current job and considers whether there are other jobs in the labor market that you could do despite your condition.  This report might include an analysis of your ability to retrain for other work, taking into account factors like your age, education, and work history.

Together, this vocational evidence provides a comprehensive picture of how your kidney or renal disease affects your professional life.  It bridges the gap between your medical condition and its practical implications for your employment, creating a strong foundation for your claim for long term disability benefits.

How can a disability insurance attorney help me get long term disability for kidney or renal disease?

For over twenty-five years, Riemer Hess has helped our clients to obtain long term disability (“LTD”) benefits, including many suffering from kidney and renal disease.  We have the knowledge and experience to effectively advocate for your rights with your insurance company and maximize your chances of securing your LTD benefits.  By adopting a thorough and tailored approach, Riemer Hess strives to lift the weight of the claims process off your shoulders, enabling you to concentrate on your health while we navigate the claims process on your behalf.

Below is an example of a Riemer Hess client with kidney disease who we helped successfully file for long term disability benefits.

Client Case Study

“Lily,” a skilled landscape architect, was diagnosed with polycystic kidney disease, which led to the need for a kidney transplant and caused significant fatigue and cognitive impairments.  These symptoms made it difficult for her to continue her demanding work in landscape design and client management.  After her condition forced her to take a leave under the Family and Medical Leave Act (“FMLA”), Lily shifted to a less physically demanding part-time consultancy role to accommodate her health limitations.  However, when her employer later denied her request to work primarily from home and began termination proceedings, Lily turned to Riemer Hess for help.

Riemer Hess quickly acted to protect Lily’s interests.  Recognizing the importance of establishing a robust claim, the firm determined her date of disability was best set at the start of her consultancy role, ensuring her higher income level and position were considered in the disability claim.  This strategic decision underscored the significant reduction in Lily’s work capacity directly related to her medical condition, not other factors.

The firm collaborated closely with Lily’s nephrologist to gather compelling medical evidence, including an opinion letter supporting her LTD claim.  Riemer Hess also organized for Lily to undergo a neuropsychological evaluation to objectively assess her cognitive impairments.  These efforts were vital in distinguishing the effects of her physical illness from her secondary depression.  Additionally, Riemer Hess helped Lily obtain a witness statement from her supervisor that substantiated how her kidney disease had impacted her work performance.

With a comprehensive array of evidence, Riemer Hess was able to successfully secure Lily’s long term disability benefits, allowing her to focus on her health and alleviating the financial pressures during her time of need.  Grateful for Riemer Hess’s invaluable assistance in the process, Lily chose to retain the firm for ongoing monitoring of her LTD claim.